By: Rachel L. MSW, LMSW
New York State Governor Andrew Cuomo reveled in his 2013-2014 Executive Budget Proposal (starting on the bottom of page 389 and continuing to 391) that he supports making licensure exemptions permanent for state funded agencies such as the Office of Children and Family Services. The exemptions also apply to:
program or service operated, regulated, funded, licensed, or approved by OMH, OPWDD, OASAS, DOH, OCFS, Office for the Aging, Department of Corrections and Community Supervision, and/or local governmental units or social services districts. (source)
Social work licensing in New York State is fairly new. Legislation that created the two levels of licensing for social workers, LMSW and LCSW, went into effect in 2004. At the same time the government also passed legislation that crated licensing for mental health counselors (LMHC).
As often happens in these cases, there were a few unintended consequences created by the new licensing laws. One such consequence was that many organizations that provided mental health services had a significant number of service providers on staff that were not properly credentialed under the new laws. Realizing that it would take time to ensure all staff where licensed, New York State gave an exemption to these organizations allowing them to keep unlicensed service providers on staff with the understanding that by July 2013 they would have their service providers appropriately licensed.
New York State NASW has worked along side the agencies for years on a plan to ensure compliance by the July 2013 deadline. The agencies in question (OMH, OASAS, OPWDD, OCFS, DOCS and SOFA) are claiming that they still do not have enough licensed staff and that should the exemptions expire it would cause them to have to carry out mass lay offs which would lead to service disruptions and cost as much as $89 million dollars. As a result the above mentioned organizations have been lobbying to make the exemptions permanent. You can read OASAS report here.
So far the only professional association I have found that supports the law is the Addictions Treatment Providers of New York. The following associations: NASW-NY, The New York Art Therapy Association, The North American Drama Association, NYS Dance Therapy Association, and the NYS Task Force on Occupational Regulations of the Mid-Atlantic Regions/American Music Therapy Association are opposed.
It appears that the reason ATPNY is supporting permanent exemptions because they agree that it would cause a workforce shortage and, there for, interruptions in services to clients. Furthermore, OASAS has some concerns that if the exemption expires some counselors would have difficulty obtaining their CASAC.
CASAC (Credentialed Alcoholism and Substance Abuse Counselor) is a credential in New York State that certifies someone has received training in addictions treatment. It is not a license, however, CASACs must go through extensive course work and field placement training. Many mental health professionals, including licensed social workers, who focus on addictions, will get a CASAC. However you do not need to have a graduate degree in a mental health field in order to become a CASAC. In fact you can get a CASAC with a high school degree or GED. You can find out more about the CASAC here.
If the exemptions become permanent it would mean that an unlicensed social worker could provide clinical services to the public. Some have also argued that it would create further disparities in our mental health system. Those who cannot pay out of pocket or who lack health insurance would be treated by unlicensed professionals while those with means can receive treatment from private practitioners who are fully credentialed.
Some of the agencies have argued that the programs that would be exempt are licensed and supervised by the Office of Mental Health, which has a record of high standards. They feel that because the unlicensed providers will be practicing in a setting regulated by OMH that this is sufficient to ensure public safety.
What do you think? Is OMH regulation a substitute for professional licensing? Have you discussed this issue with your assemblymen or the Governor’s office? If so, what was their response?